Secondary Candidemia in Critically Ill COVID-19 Patient

T2Candida enabled the detection of candidemia 29 hours before a positive blood culture was returned. Early detection allowed for the rapid initiation of antifungal therapy in a critically ill COVID-19 patient.

Lee Health | Fort Myers, Florida

Patient History

Age and Sex: Elderly Male
History: Patient was admitted to the hospital with confirmed COVID-19. His past medical history included Type 2 diabetes mellitus and hypertension
Presentation: The patient required oxygen support via nasal cannula. A chest radiograph showed bibasilar infiltrates and initial blood cultures were negative.
Risk Factors: The patient had multiple risk factors for candidemia during hospitalization.

  • Presence in ICU
  • Broad-spectrum antimicrobial therapy
  • Immunosupressing medications

Evaluation and Treatment

Day 1
The patient was initiated on azithromycin and methylprednisolone, was given one dose of convalescent plasma

Day 2
Patient was administered 1 dose of tocilizumab (8mg/kg)

Day 3
Patient was intubated for worsening respiratory status

Day 14
Patient developed new fever, chest x-ray showed increased opacities, broad-spectrum antimicrobial therapy was initiated for suspected bacterial pneumonia

Day 15 & 16
Fever escalates (Tmax 101.9F and 103F, respectively). Additional blood cultures were obtained and T2Candida was ordered. T2Candida was positive for Candida albicans/Candida tropicalis 29 hours before the positive blood culture. On the evening of day 16 anidulafungin was initiated

Day 18
Patient defervesced

Day 30
Patient was discharged to a long-term acute care center

 

  1. Cubillos, A., et al. CAP, 2021

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